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Objective: Monochorionic diamniotic twin pregnancies complicated by Type-III selective fetal growth restriction (sFGR) are at high risk of fetal death. The aim of this study was to identify predictors of fetal death in these pregnancies.Methods: This was an international multicenter retrospective cohort study. Type-III sFGR was defined as fetal estimated fetal weight (EFW) of one twin below the 10th percentile and intertwin EFW discordance of ≥ 25% in combination with intermittent absent or reversed end-diastolic flow in the umbilical artery of the smaller fetus. Predictors of fetal death were recorded longitudinally throughout gestation and assessed in univariable and multivariable logistic regression models. The classification and regression trees (CART) method was used to construct a prediction model of fetal death using significant predictors derived from the univariable analysis.Results: A total of 308 twin pregnancies (616 fetuses) were included in the analysis. In 273 (88.6%) pregnancies, both twins were liveborn, whereas 35 pregnancies had single (n = 19 (6.2%)) or double (n = 16 (5.2%)) fetal death. On univariable analysis, earlier gestational age at diagnosis of Type-III sFGR, oligohydramnios in the smaller twin and deterioration in umbilical artery Doppler flow were associated with an increased risk of fetal death, as was larger fetal EFW discordance, particularly between 24 and 32 weeks' gestation. None of the parameters identified on univariable analysis maintained statistical significance on multivariable analysis. The CART model allowed us to identify three risk groups: a low-risk group (6.8% risk of fetal death), in which umbilical artery Doppler did not deteriorate; an intermediate-risk group (16.3% risk of fetal death), in which umbilical artery Doppler deteriorated but the diagnosis of sFGR was made at or after 16 + 5 weeks' gestation; and a high-risk group (58.3% risk of fetal death), in which umbilical artery Doppler deteriorated and gestational age at diagnosis was < 16 + 5 weeks' gestation.Conclusions: Type-III sFGR is associated with a high risk of fetal death. A prediction algorithm can help to identify the highest-risk group, which is characterized by Doppler deterioration and early referral. Further studies should investigate the potential benefit of fetal surveillance and intervention in this cohort. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: Little is known regarding fetal growth patterns in monochorionic twin pregnancy complicated by Type-III selective fetal growth restriction (sFGR). We aimed to assess fetal growth and umbilical artery Doppler pattern in Type-III sFGR across gestation and evaluate the effect of changing Doppler flow pattern on growth and intertwin growth discordance.Methods: This was a retrospective cohort study of all Type-III sFGR pregnancies managed at nine fetal centers over a 12-year time period. Higher-order multiple pregnancy and cases with major fetal anomaly or other monochorionicity-related complications at presentation were excluded. Estimated fetal weight (EFW) was assessed on ultrasound for each twin pair at five timepoints (16-20, 21-24, 25-28, 29-32 and > 32 weeks' gestation) and compared with singleton and uncomplicated monochorionic twin EFW. EFW and intertwin EFW discordance were compared between pregnancies with normalization of umbilical artery Doppler of the smaller twin later in pregnancy and those with persistently abnormal Doppler.Results: Overall, 328 pregnancies (656 fetuses) met the study criteria. In Type-III sFGR, the smaller twin had a lower EFW than an average singleton fetus (EFW Z-score ranging from -1.52 at 16 weeks to -2.69 at 36 weeks) and an average monochorionic twin in uncomplicated pregnancy (Z-score ranging from -1.73 at 16 weeks to -1.49 at 36 weeks) throughout the entire gestation, while the larger twin had a higher EFW than an average singleton fetus until 22 weeks' gestation and was similar in EFW to an average uncomplicated monochorionic twin throughout gestation. As pregnancy advanced, growth velocity of both twins decreased, with the larger twin remaining appropriately grown and the smaller twin becoming more growth restricted. Intertwin EFW discordance remained stable throughout gestation. On multivariable longitudinal modeling, normalization of fetal umbilical artery Doppler was associated with better growth of the smaller twin (P = 0.002) but not the larger twin (P = 0.1), without affecting the intertwin growth discordance (P = 0.09).Conclusions: Abnormal fetal growth of the smaller twin in Type-III sFGR was evident early in pregnancy, while EFW of the larger twin remained normal throughout gestation. Normalization of umbilical artery Doppler was associated with improved fetal growth of the smaller twin. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Type-III selective intrauterine growth restriction (sIUGR) is associated with a high and unpredictable risk of fetal death and fetal brain injury. The objective of this study was to describe the prospective risk of fetal death and the risk of adverse neonatal outcome in a cohort of twin pregnancies complicated by Type-III sIUGR and treated according to up-to-date guidelines.Methods: We reviewed retrospectively all monochorionic diamniotic twin pregnancies complicated by Type-III sIUGR managed at nine fetal centers over a 12-year period. Higher-order multiple gestations and pregnancies with major fetal anomalies or other monochorionicity-related complications at initial presentation were excluded. Data on fetal and neonatal outcomes were collected and management strategies reviewed. Composite adverse neonatal outcome was defined as neonatal death, invasive ventilation beyond the resuscitation period, culture-proven sepsis, necrotizing enterocolitis requiring treatment, intraventricular hemorrhage Grade > I, retinopathy of prematurity Stage > II or cystic periventricular leukomalacia. The prospective risk of intrauterine death (IUD) and the risk of neonatal complications according to gestational age were evaluated.Results: We collected data on 328 pregnancies (656 fetuses). After exclusion of pregnancies that underwent selective reduction (n = 18 (5.5%)), there were 51/620 (8.2%) non-iatrogenic IUDs in 35/310 (11.3%) pregnancies. Single IUD occurred in 19/328 (5.8%) pregnancies and double IUD in 16/328 (4.9%). The prospective risk of non-iatrogenic IUD per fetus declined from 8.1% (95% CI, 5.95-10.26%) at 16 weeks, to less than 2% (95% CI, 0.59-2.79%) after 28.4 weeks and to less than 1% (95% CI, -0.30 to 1.89%) beyond 32.6 weeks. In otherwise uncomplicated pregnancies with Type-III sIUGR, delivery was generally planned at 32 weeks, at which time the risk of composite adverse neonatal outcome was 29.0% (31/107 neonates). In twin pregnancies that continued to 34 weeks, there was a very low risk of IUD (0.7%) and a low risk of composite adverse neonatal outcome (11%).Conclusions: In this cohort of twin pregnancies complicated by Type-III sIUGR and treated at several tertiary fetal centers, the risk of fetal death was lower than that reported previously. Further efforts should be directed at identifying predictors of fetal death and optimal antenatal surveillance strategies to select a cohort of pregnancies that can continue safely beyond 33 weeks' gestation. © 2020 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

First trimester screening for pre-eclampsia (PE) combining uterine artery Doppler (UtA-PI), mean arterial pressure (MAP) and placental growth factor (PlGF) with the background risk allows the best prediction of preterm PE (pPE). Only median PAPP-A-MoM measured significantly different by the two calculations with 1.12 [0.79-1.55] and 1.24 [0.83-1.69] respectively (p = 0.0045). Combining UtA-PI, MAP and PlGF on the online calculator 141/995 (14.2%) had a risk > 1:100 and at the SPR of 11% the cut-off is 1:68. [Extracted from the article]

Results In total, 28 singleton pregnancies with gastroschisis and 24 singleton pregnancies with omphalocele met the inclusion criteria. Gastroschisis and omphalocele are the two most common congenital fetal abdominal wall defects (AWDs). EP23.09: Placental and neonatal weight in fetuses with abdominal wall defects: gastroschisis versus omphalocele - where is the fetus smaller?. [Extracted from the article]

Previous studies have shown that fetuses with congenital heart disease (CHD) and associated extracardiac malformations or genetic anomalies are at an increased risk for intrauterine fetal death (IUFD). Birthweight percentiles were lowest for LSL and UD, 31% of included cases ranked below the 10 SP th sp percentile. Conclusions Our study shows that birthweight percentiles of IUFD with a LSL indicate a possible placental insufficiency, which could be another reason for IUFD. [Extracted from the article]

Objective Our purpose was to evaluate the antenatal incidence of single umbilical artery (SUA) in twin pregnancies according to chorionicity and to assess its relationship with outcome. Methods Consecutive twin pregnancies undergoing ultrasound evaluation at our institutions were included. A targeted sonographic evaluation of the umbilical cord and vessels was performed in all cases. Chorionicity was determined according to standard ultrasound criteria. Results A total of 174 twin pregnancies, 100 dichorionic (DC) and 74 monochorionic (MC), were included in the study. An SUA was identified in 17 (9.8%) pregnancies, and in 18 (5.2%) fetuses. No difference was found in the incidence of SUA in DC and MC twins. Among affected pregnancies, all but one DC twin pregnancy were discordant for SUA. Structural and/or chromosomal abnormalities were present in 27.8% of fetuses with SUA. The prevalence of small-for-gestational-age fetuses and of discordant birth weight (> 20% discordance) was higher in the SUA group than in the rest of the population, although these differences were not statistically significant. Twin pairs discordant for SUA had significantly higher weight discordance than those with normal umbilical cords. The sonographic cross-sectional area of the SUA did not appear to show the typical adaptive dilatation usually seen in singleton pregnancies with SUA. Conclusions The incidence of SUA in twins is higher than in singletons, with no difference between MC and DC twins. Intrapair discordance for SUA in identical twins provides evidence against an exclusively genetic origin of this anomaly. The apparent failure of compensatory dilatation of the umbilical artery in twins with SUA may explain in part the higher risk for fetal growth restriction in these cases. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective The primary aim of this study was to determine the desires and wishes of pregnant patients vis-à-vis their external genital anatomy after female genital mutilation (FGM) in the context of antenatal care and delivery in a teaching hospital setting in Switzerland. Our secondary aim was to determine whether women with FGM and non-mutilated women have different fetal and maternal outcomes. Design A retrospective case–control study. Setting A teaching hospital. Population One hundred and twenty-two patients after FGM who gave consent to participate in this study and who delivered in the Department of Obstetrics and Gynaecology in the University Hospital of Berne and 110 controls. Methods Data for patients’ wishes concerning their FGM management, their satisfaction with the postpartum outcome and intrapartum and postpartum maternal and fetal data. As a control group, we used a group of pregnant women without FGM who delivered at the same time and who were matched for maternal age. Main outcome measures Patients’ satisfaction after delivery and defibulation after FGM, maternal and fetal delivery data and postpartum outcome measures. Results Six percent of patients wished to have their FGM defibulated antenatally, 43% requested a defibulation during labour, 34% desired a defibulation during labour only if considered necessary by the medical staff and 17% were unable to express their expectations. There were no differences for FGM patients and controls regarding fetal outcome, maternal blood loss or duration of delivery. FGM patients had significantly more often an emergency Caesarean section and third-degree vaginal tears, and significantly less first-degree and second-degree tears. Conclusion An interdisciplinary approach may support optimal antenatal and intrapartum management and also the prevention of FGM in newborn daughters. [ABSTRACT FROM AUTHOR]

The article focuses on the study which determines whether a large sonographic cross-sectional area of the umbilical cord is a predictor of fetal macrosomia. Accordingly, the patients have undergone sonographic cross-sectional areas of the umbilical cord, the umbilical vessels and the Wharton's jelly. Thus, sonographic assessment of umbilical cord area may improve the prediction of fetal macrosomia.

Of the several uterine compression sutures described in more recent years to treat postpartum haemorrhage (PPH), the Hayman suture offers the potential advantages that can be applied faster and easier, avoiding the performance of a lower segment hysterotomy when PPH follows a vaginal delivery. Data on efficacy and safety are limited, and long-term follow-up information are lacking. We report our experience with the Hayman suture in 11 consecutive women with massive PPH. Of these, ten were successfully treated without further interventions. One woman ultimately required a hysterectomy. Postoperative course was uncomplicated in all the cases. The median follow-up time was 11 months (range 1–19). One woman conceived spontaneously 10 months after the procedure. Our results suggest that the Hayman suture is an effective and safe treatment for PPH. [ABSTRACT FROM AUTHOR]

Objectives Sonographic Doppler evaluation of the fetal ductus venosus has been proved to be useful in the evaluation of fetal cardiac function. The aim of this study was to investigate the ductus venosus blood flow profile in fetuses with single umbilical artery and to correlate it with the umbilical cord morphology. Methods Fetuses at > 20 weeks' gestation with single umbilical artery who were otherwise healthy were consecutively enrolled into the study. The sonographic examination included evaluation of the following Doppler parameters: umbilical artery resistance index, maximum blood flow velocity of the ductus venosus during ventricular systole (S-peak) and atrial contraction (A-wave), ductus venosus time-averaged maximum velocity (TAMXV), and pulsatility index for veins (PIV). The cross-sectional area of the umbilical cord and its vessels were measured in all cases. The Doppler and morphometric values obtained were plotted on reference ranges. Results A total of 88 fetuses with single umbilical artery were scanned during the study period. Of these 52 met the inclusion criteria. The S-peak velocity, A-wave velocity, and TAMXV were below the 5th centile for gestational age in 57.7%, 59.6%, and 57.7% of cases, respectively. The PIV was within the normal range in 80.1% of cases. The umbilical vein cross-sectional area of fetuses with single umbilical artery was above the 95th centile for gestational age in 34.6% cases. Conclusions The ductus venosus blood flow pattern is different in fetuses with single umbilical artery from that in those with a three-vessel cord. This difference may be caused in part by the particular morphology of umbilical cords with a single artery. [ABSTRACT FROM AUTHOR]

Objective To investigate the prevalence of single and multiple umbilical cord cysts in the first trimester and to assess whether there is a difference in the pregnancy outcome between them. Methods A targeted sonographic morphological and morphometric evaluation of the umbilical cord was performed in consecutive patients between 7 and 14 weeks of gestation. Crown-rump length and umbilical cord diameter were measured in all cases. Nuchal translucency thickness was measured between 11 and 14 weeks' gestation. In pregnancies at very early gestational ages (7-10 weeks) an additional scan was performed between 11 and 14 weeks. Results A total of 1159 patients was screened. The prevalence of umbilical cord cysts was 2.1% (24/1159). The cysts were single and multiple in 18 and six cases, respectively. The median (range) largest umbilical cord cyst diameter was no different between multiple and single umbilical cord cysts (3.8 (2.1-18) mm vs. 3.05 (2.0-7.8) mm; P = 0.386). All women with a single umbilical cord cyst delivered an infant without structural abnormalities and without features suggestive of chromosomal abnormalities. Among the women with multiple umbilical cord cysts, four had a missed miscarriage and one had a fetus with obstructive uropathy. Conclusion Single and multiple umbilical cord cysts in the first trimester of gestation represent two different entities. While single cysts in the first trimester are associated with a favorable pregnancy outcome, the presence of multiple umbilical cord cysts is associated with an increased risk of miscarriage and aneuploidy. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To compare the umbilical cord diameter at 10–14 weeks of gestation of chromosomally normal and abnormal fetuses. Methods In a consecutive series of women, who were undergoing routine sonographic evaluation at 10–14 weeks of gestation, umbilical cord diameter and nuchal translucency were measured. Reference ranges for umbilical cord diameter according to gestational age and crown–rump length were constructed. Fetal karyotype was obtained at chorionic villus sampling, amniocentesis or at delivery in newborns with features suspicious for chromosomal abnormalities. Results During the study period, 784 patients met the inclusion criteria. Of these, a fetal or placental chromosomal abnormality was present in 17 cases. The mean umbilical cord diameter increased with gestational age (r = 0.41, P < 0.001). The proportion of fetuses with an umbilical cord diameter above the 95th centile was higher in the presence of fetal or placental chromosomal abnormalities than in normal fetuses (5/17 vs. 39/767, P < 0.01). Among fetuses with an abnormal fetal or placental karyotype, nuchal translucency was above the 95th centile for gestational age in 10 cases. When only fetal chromosomal abnormalities were considered (n = 14), the combined detection rate was 85.7% (12/14). Conclusions Sonographic assessment of the umbilical cord in early gestation appears to identify a subset of fetuses at increased risk of chromosomal abnormalities. [ABSTRACT FROM AUTHOR]

Abstract Objectives Experimental and clinical evidence have shown that the morphometry of the umbilical cord in the second half of gestation might be useful in predicting adverse perinatal outcome. The purposes of this study were to generate a nomogram for the umbilical cord diameter in the first trimester and, in an observational study, to investigate whether the sonographic measurement of the umbilical cord diameter early in gestation has the same clinical value as that late in gestation. Methods The sonographic umbilical cord diameter, crown-rump length and biparietal diameter were measured in 439 fetuses at between 8 and 15 weeks of gestation. The perinatal outcome was recorded for all patients. Results The umbilical cord diameter increased steadily from 8 to 15 weeks of gestation. A significant correlation was found between umbilical cord diameter and gestational age (r = 0.78; P < 0.001), umbilical cord diameter and crown-rump length (r = 0.75; P < 0.001) and umbilical cord diameter and biparietal diameter (r = 0.81; P < 0.001). No correlation was found between umbilical cord diameter values and either birth weight or placental weight. Among patients who had a miscarriage (n = 7) and pre-eclampsia (n = 8) the umbilical cord diameter was below 2 standard deviations from the mean in three cases (42.9%) and three cases (37.5%), respectively. Conclusion The measurement of the umbilical cord diameter in the first trimester is correlated with the growth of the embryo and may be a marker for identifying a subset of fetuses at risk of spontaneous miscarriage and pre-eclampsia. [ABSTRACT FROM AUTHOR]

AbstractObjectivesTo generate a nomogram for the sonographic measurement of Wharton’s jelly area (WJA) during gestation and to investigate whether WJA is related to fetal biometric parameters. MethodThe sonographic cross-sectional area of the umbilical cord and of its vessels was measured in 659 fetuses between 15 and 42 weeks of gestation. The WJA was calculated by subtracting the vascular area from the umbilical cord area. The conventional biometric parameters were measured and correlated with the WJA. Polynomial regression analysis was utilized for statistical purposes. ResultsThe WJA increased as a function of gestational age (r = 0.63, P < 0.001). The regression equation for the mean WJA (y) according to gestational age (x) was y = -114.7 + 4.142x - 0.01x2 and for the standard deviation (y′) was y′ = -7.567 + 1.319x. There was a strong correlation between the WJA and the umbilical cord area (r = 0.97, P < 0.001). A significant correlation was also found between the WJA and fetal biometric parameters before 32 weeks of gestation (WJA and biparietal diameter: r = 0.82, P < 0.001; WJA and abdominal circumference: r = 0.79, P < 0.001; WJA and femur length: r = 0.81, P < 0.001) while after 32 weeks of gestation no correlations were found between WJA and fetal anthropometric parameters. ConclusionA nomogram for the WJA has been generated. The WJA increases as a function of gestational age and it is correlated with fetal size up to 32 weeks of gestation. [ABSTRACT FROM AUTHOR]

Abstract Objective To evaluate whether umbilical vascular coiling is correlated with the umbilical vein blood flow profile and to investigate if this is different between fetuses with a lean and those with a normal umbilical cord. Methods Consecutive women with a singleton gestation who delivered at term and who underwent an ultrasound examination within 24 h from delivery were studied. Umbilical cord and vessel areas were calculated. Umbilical vein blood flow parameters were obtained by digital color Doppler velocity profile integration. After delivery, the umbilical coiling index was calculated. Results One hundred and sixteen women were studied. Twelve (10.3%) had a lean umbilical cord (area < 10th centile). A significant correlation was found between the umbilical coiling index and the umbilical vein blood flow (r = 0.67, P < 0.001). A significant difference between fetuses with and without a lean cord was found in terms of: umbilical coiling index (0.18 ± 0.08 vs. 0.29 ± 0.09, P < 0.005), cord area (87.6 ± 5.1 mm2 vs. 200.6 ± 34.6 mm2, P < 0.001), Wharton’s jelly amount (25.7 ± 10.3 mm2 vs. 122.1 ± 33.4 mm2, P < 0.001), umbilical vein blood flow (93.7 ± 17.8 ml/kg per min vs. 126.0 ± 23.4 ml/kg per min, P < 0.001), and umbilical vein blood flow mean velocity (6.6 ± 2.7 cm/s vs. 9.0 ± 3.6 cm/s, P < 0.05). The proportion of fetuses with an umbilical vein blood flow < 80 ml/kg per min was higher when the cord was lean than when it was normal (25% vs. 1.9%, P < 0.01). Conclusions Lean umbilical cords differ from normal cords not only from a structural point of view but also in the umbilical vein blood flow characteristics. This could explain the increased incidence of intrapartum complications and fetal growth restriction among fetuses with a lean and/or hypocoiled cord. [ABSTRACT FROM AUTHOR]

Conclusions Abnormal fetal growth of the smaller twin in type 3 sFGR was evident from early in pregnancy, while the larger twin's growth remained normal throughout gestation. We aimed to assess fetal growth and Doppler patterns in type 3 sFGR across gestation and evaluate the effect of changing Doppler flow patterns on growth and intertwin weight discordance. OP04.02: Growth patterns of monochorionic twin pregnancies complicated by type-3 selective fetal growth restriction. [Extracted from the article]

Objective: To investigate whether the amount of Wharton's jelly in non-malformed fetuses with a single umbilical artery is different from that of fetuses with a normal umbilical cord. Methods: We evaluated patients with singleton pregnancies, non-malformed fetuses and single umbilical artery undergoing sonographic evaluation at a gestational age ranging from 19 to 41 weeks' gestation. The cross-sectional areas of the umbilical cord and of the umbilical vessels were measured. The amount of Wharton's jelly was calculated by subtracting from the total cross-sectional area of the umbilical cord the areas of the artery and of the vein. The umbilical cord cross-sectional area, the umbilical artery and vein areas as well as the amount of Wharton's jelly were plotted on previously published nomograms. Results: Twenty-two patients met the inclusion criteria. The umbilical cord cross-sectional area was within the normal range in 20 (90.1%) cases. The umbilical artery and vein areas were above 2 standard deviations from the mean in 20 cases and in 11 cases (50%), respectively. The amount of Wharton's jelly was below 2 standard deviations from the mean in all cases. An abnormal insertion of the umbilical cord (marginal, velamentous) was present in five cases (22.7%). Conclusions: A reduction of Wharton's jelly is frequently present in cases of single umbilical artery. The increased perinatal morbidity and mortality observed in cases of single umbilical artery, even in the absence of congenital or chromosomal abnormalities, could be in part the consequence of a reduced amount of Wharton's jelly. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to investigate whether the prenatal diagnosis of a ‘lean’ umbilical cord in otherwise normal fetuses identifies fetuses at risk of being small for gestational age (SGA) at birth and of having distress in labor. The umbilical cord was defined as lean when its cross-sectional area on ultrasound examination was below the 10th centile for gestational age. Method Pregnant women undergoing routine sonographic examination were included in the study. Inclusion criteria were gestational age greater than 20 weeks, intact membranes, and singleton gestation. The sonographic cross-sectional area of the umbilical cord was measured in a plane adjacent to the insertion into the fetal abdomen. Umbilical artery Doppler waveforms were recorded during fetal apnea and fetal anthropometric parameters were measured. Results During the study period, 860 patients met the inclusion criteria, of whom 3.6% delivered a SGA infant. The proportion of SGA infants was higher among fetuses who had a lean umbilical cord on ultrasound examination than among those with a normal umbilical cord (11.5% vs. 2.6%, p < 0.05). Fetuses with a lean cord had a risk 4.4-fold higher of being SGA at birth than those with a normal umbilical cord. After 25 weeks of gestation, this risk was 12.4 times higher when the umbilical cord was lean than when it was of normal size. The proportion of fetuses with meconium-stained amniotic fluid at delivery was higher among fetuses with a lean cord than among those with a normal umbilical cord (14.6% vs. 3.1%, p < 0.001). The proportion of infants who had a 5-min Apgar score < 7 was higher among those who had a lean cord than among those with normal umbilical cord (5.2% vs. 1.3%, p < 0.05). Considering only patients admitted in labor with intact membranes and who delivered an appropriate-for-gestational-age infant, the proportion of fetuses who had oligohydramnios at the time of delivery was higher among those who h... [ABSTRACT FROM AUTHOR]

Recently, a new parameter of the posterior fossa (PF), the Vermian-Crest Angle (VCA), has been tested in normal pregnancies. Based on these landmarks, the VCA was measured, defined by the convergence of two lines: the first, tangent to the internal occipital crest; the second, tangent to the nodulus vermis, as already reported. 24 fetuses at 19-28 weeks with Blake's pouch cyst (BPC) (n=4), Dandy-Walker Malformation (DWM) (n=5), Mega Cisterna Magna (MCM) (n= 8) and Vermian Hypoplasia (VH) (n=7) were identified. [Extracted from the article]

Conjoined twins(CT) are a rare complication of monozygotic twinning(MT) in which one or more organs are joined in utero. Although the embryopathogenesis of these cases remains a lively focus of interest, the impact on the development of the umbilical cord(UC) and its vessels in CT remains still poorly investigated1 . This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

The article focuses on the use of pulsed Doppler sonography connected with recording of blood flow for the evaluation of fetal atrioventricular (AV) conduction time.

To evaluate the correlation between placental pathology classified as "jelly like" and spherically thick placenta, Doppler parameters and angiogenetic factors sFlt-1and PLGF and their ratio. A significant correlation was seen between UA PI, PlGF (r=0.60; p 0.004) and ratio (r= 0.38; p 0.05), utA PI, PLGF (r=0.47; p 0.03); birthweight, PLGF (r=0.72, p 0.01) and placenta weight, PlGF (r= 0.74; p 0.001) and ratio (r=0.49; p 0.02) in group 1 and between UA PI, PlGF (r=0.49; p 0.01) and ratio (r= 0.49; p 0.007), utA PI, PlGF (r= 0.55; p 0.004), birthweight, PlGF (r= 61; p 0.002) and ratio (r= 0.55; p 0.003) and placenta weight, PlGF (r= 0.65; p 0.001) and ratio (r= 0.55; p 0.005) in group 2. Both placenta pathologies, in particular "jelly like" placenta, are sonomorphologic signs for a severe angiogenetic disturbance and correlated with changes in fetomaternal hemodynamic and outcome. [Extracted from the article]

An abstract of the article "Non-specific fetal ascites in a woman with active hepatitis C," by G. Sciotti, L. Raio, and S. Michaelis is presented.

An abstract of the article "Effects of early aspirin therapy on uteroplacental hemodynamics of risk patients for pre-eclampsia," by C. Hofstaetter, L. Raio, and D. Surbek is presented.

An abstract of the article "Prenatal diagnosis of diaphanospondylodystosis (DSD): a case report," by C. Hofstaetter and L. Raio is presented.

The article presents two cases of monochorionic diamniotic (MCDA) twin pregnancy with severe fetal anemia in which a blood transfusion was performed. It mentions that in the first case, Kleihauer-Betke test was positive and fetomaternal hemorrhage was diagnosed. It reveals that the second case was a 36-year-old primigravida with a MCDA twin pregnancy. It mentions that cesarean section was performed due to appearance of placental insufficiency.

An abstract of the research paper "Monochorionic Twins With Selective Growth Restriction: Is the "Gratacós Classification" Justified?" by C. Hofstaetter and colleagues is presented.

An abstract of the conference paper "Megacystis: diagnosis, therapy and outcome," by L. Raio and colleagues is presented.

An abstract of the conference paper "Yield of invasive diagnostic procedures by indications," by M. U. Baumann and colleagues is presented.

An abstract of the conference paper "The umbilical cord in Cantrell: pentalogy or hexalogy?," by A. Muller Brochut and colleagues is presented.

An abstract of the conference paper "One for two: fetal and placental weights of MC and DC twins" by L. Raio and colleagues is presented.

Background: Pregnant women with obesity are more likely to experience cesarean birth compared to women without obesity. Yet, little is known about the underlying mechanisms. The objective of this study was therefore to evaluate how mediators contribute to the association between obesity and prelabor/intrapartum cesarean birth., Methods: We retrospectively analyzed Swiss cohort data from 394,812 singleton, cephalic deliveries between 2005 and 2020. Obesity (BMI ≥ 30 kg/m 2 ) was defined as the exposure and prelabor or intrapartum cesarean birth as the outcomes. Hypothesized mediators included gestational comorbidities, large-for-gestational-age infant, pregnancy duration >41 0/7 weeks, slower labor progress, labor induction, and history of cesarean birth. We performed path analyses using generalized structural equation modeling and assessed mediation by a counterfactual approach., Results: Women with obesity had a cesarean birth rate of 39.36% vs. 24.12% in women without obesity. The path models mainly showed positive direct and indirect associations between obesity and cesarean birth. In the total sample, the mediation models explained up to 39.47% (95% CI 36.92-42.02) of the association between obesity and cesarean birth, and up to 57.13% (95% CI 54.10-60.16) when including history of cesarean birth as mediator in multiparous women. Slower labor progress and history of cesarean birth were found to be the most clinically significant mediators., Conclusions: This study provides empirical insights into how obesity may increase cesarean birth rates through mediating processes. Particularly allowing for a slower labor progress in women with obesity might reduce cesarean birth rates and prevent subsequent repeat cesarean births in multiparous women., (© 2023 The Authors. Birth published by Wiley Periodicals LLC.)

Of the several uterine compression sutures described in more recent years to treat postpartum haemorrhage (PPH), the Hayman suture offers the potential advantages that can be applied faster and easier, avoiding the performance of a lower segment hysterotomy when PPH follows a vaginal delivery. Data on efficacy and safety are limited, and long-term follow-up information are lacking. We report our experience with the Hayman suture in 11 consecutive women with massive PPH. Of these, ten were successfully treated without further interventions. One woman ultimately required a hysterectomy. Postoperative course was uncomplicated in all the cases. The median follow-up time was 11 months (range 1-19). One woman conceived spontaneously 10 months after the procedure. Our results suggest that the Hayman suture is an effective and safe treatment for PPH.